By N. Söderström (auth.), Karl Lennert o. Prof. Dr., Dieter Harms Dr. (eds.)

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Extra resources for Die Milz / The Spleen: Struktur, Funktion Pathologie, Klinik, Therapie / Structure, Function, Pathology Clinical Aspects, Therapy

Sample text

Die andere Form ist die mit groBem Milztumor und cytopenischem Blutbild. Bei diesen Formen sehen wir ein ahnliches Verhalten wie bei der Myelofibrose. Das Funktionsbild widerspiegelt stets die histologischen Veranderungen im Bereich der roten Pulpa. Bei der Myelofibrose sind die Filtrationsraume noch ausreichend groB, urn eine kleine Menge warmealterierter Erythrocyten aufzunehmen. Bei der chronischmyeloischen Leukamie ist hingegen die gesamte rote Pulpa so weitgehend umgebaut, daB sie auch eine kleine Menge warmealterierter Erythrocyten (3-5 ml) nicht mehr mit der ublichen Geschwindigkeit aufnehmen kann.

1958; TOGHILL). Because the retention of erythrocytes under pathologic conditions occurs primarily in the splenic cords, the pulp cords have been equated with the slow compartment while that portion of the circulation in which the cords are bypassed corresponds to the rapid compartment of the splenic circulation (RICHARDS and TOGHILL, JANDL and ASTER). The relative proportions of cellular elements which enter the sinuses or the cords vary and are controlled by occlusive mechanisms in the terminal arterioles, the hydrostatic pressure within the sinuses and perhaps by other factors not yet clearly understood.

Erythroclasia Fragmentation of abnormal erythrocytes with the appearance of red cell fragments in the circulation The pathologic alterations observed in splenic enlargement which occur in disorders affecting primarily the red pulp are tabulated in Table 2. Not all of these have been discussed in detail but it is evident from this table that splenic sequestration of formed elements of the blood are usually attributable to extrasplenic causes, either abnormalities in the formed elements of the blood or factors which increase the macrophages of the pulp cords.

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